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At a glance: Indonesia

Indonesia fights polio outbreak

An Indonesian child is vaccinated against polio, during a UNICEF-supported immunization campaign in Cipanengah village, Sukabumi, West Java.

By Kun Li and Claire Hajaj

WEST JAVA, Indonesia, 6 May 2005 – The Indonesian Health Ministry today confirmed that another child has been paralysed by polio, bringing the total to five so far in the current outbreak. Officials have informed UNICEF that a further nine suspected polio cases are being investigated.

“From the stool samples, it seems obvious that the virus has an almost identical genotype as the west African polio virus, which was recently found in Saudi Arabia,” said UNICEF Health Officer Budi Subianto.

The five confirmed polio cases were found in three subdistricts near Sukabumi District, about 100 km south of Jakarta. The subdistricts include Cidahu, the site of the original outbreak, and neighboring Cicurug and Bojong Genteng. The nine suspected cases are located within the same general area.

Supported by UNICEF, Indonesian health officials are vaccinating children to try to prevent further spread of the disease. In just 2 days, more than 4,000 children in Cidahu have been immunized. Over 1,300 children from neighbouring Bojong Genteng subdistrict will soon be immunized as well.

UNICEF will contribute $1.1 million towards a broader immunization campaign later this month. An estimated 5.2 million children throughout Western Java, including the capital Jakarta, will be vaccinated against polio during the massive campaign.

A girl shows her inked finger after getting a polio vaccination in Cipanengah village.

This is Indonesia’s first case of polio since 1995. Routine immunization against polio in Indonesia is estimated at 70 per cent overall, although there are pockets where immunity against the virus is far lower.

"This importation is a tragedy for the children concerned, and highlights our global vulnerability to polio wherever children are un-immunized,” said Dr. Peter Salama, UNICEF Chief of Immunization. “Until services like immunization are available to all children equally, the world will be vulnerable to infectious diseases.”

Indonesia is the 16th country to be affected by an ongoing polio outbreak, which began in West Africa last year and has since spread beyond the continent.

The spark was lit in northern Nigeria in late 2003, when polio immunization campaigns were temporarily suspended in one of the last major reservoirs of the disease. The virus spread rapidly across Africa, its advance fuelled by low immunization rates in many African countries. Civil conflict has also played its part in Chad, Sudan and Cote d’Ivoire – eroding health systems, cutting children from immunization drives and sending waves of people fleeing from their homes across borders.

“These are perfect conditions to spur the spread of a highly infectious virus like polio, which thrives on low immunity levels and unsanitary living conditions,” said Dr. Salama.

A young boy receives polio vaccine while his finger is marked with ink.

Importations of polio have now been recorded in Ethiopia, Yemen and Saudi Arabia. Concern is growing for polio-free countries in the Middle East and particularly the Horn of Africa, where immunization rates are low and children are highly vulnerable.

Africa has responded in force to the threat of polio. A total of 23 countries have participated in at least two rounds of mass synchronized immunization campaigns so far this year, aiming to reach 100 million children in the world’s largest ever coordinated public health event.

Epidemiologists say outbreaks like the one in Indonesia can be stopped fast by high quality immunization campaigns and strong surveillance. The real challenge remains stopping polio transmission in six endemic countries – Nigeria, Niger, Egypt, India, Pakistan and Afghanistan. The prospects are encouraging: Polio transmission has fallen globally by 99 per cent as a result of the global drive for eradication, and health officials are confident that it can soon be stopped for good.